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Mixing Sumatriptan: A Prospective Study of Stratified Care Using Multiple Formulations
Author(s) -
Kaniecki Robert G.
Publication year - 2001
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2001.01157.x
Subject(s) - sumatriptan , medicine , tolerability , migraine , adverse effect , anesthesia , nasal spray , prospective cohort study , population , surgery , nasal administration , pharmacology , receptor , environmental health , agonist
Objective.—To assess the acceptability, utility, and tolerability of a system of stratified care of acute migraine using multiple formulations of sumatriptan. Background.—Stratified care matches the treatment of a disease to its level of severity. Sumatriptan, with its multiple formulations, seems a logical option in a stratified care approach. Little data exists on the use of multiple formulations in a single patient population. Design and Methods.—A prospective, open‐label, outpatient study recruited patients from a single center during the period from January 1998 through June 1998. Entry criteria included International Headache Society migraine diagnostic codes 1.1 or 1.2 and an established response to sumatriptan tablets or nasal spray. Patients who enrolled were allowed to use subcutaneous sumatriptan as either primary or rescue therapy for individual migraine attacks. Results.—Two hundred eighteen (80%) of 273 patients on tablets and 40 (85%) of 47 patients on nasal spray enrolled. During a period of 6 months, 61% of the patients on tablets and 85% of the patients using the nasal spray used at least one subcutaneous dose of sumatriptan. This system was efficacious and well tolerated. The majority of injections were used as rescue treatments following a failed oral or nasal dose. Two percent withdrew due to lack of efficacy, and 6% withdrew due to adverse events; however, 92% professed satisfaction with subcutaneous sumatriptan as an available tool for migraine management. Conclusion.—A system of stratified care using multiple formulations of sumatriptan is efficacious, well tolerated, and preferable to a program involving a single form of the drug.